Randomized comparison of percutaneous transluminal coronary angioplasty and medical therapy in stable survivors of acute myocardial infarction with single vessel disease: a study of the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte.

Background: Percutaneous transluminal coronary angioplasty of the infarct-related artery in stable survivors of acute myocardial infarction is often performed, even in patients without any symptoms or residual ischemia. Despite the lack of randomized studies, it is widely believed that this intervention will improve the clinical outcome of these patients.

Methods And Results: Three hundred patients with single vessel disease of the infarct vessel and no or minor angina pectoris in the subacute phase (1 to 6 weeks) after an acute myocardial infarction were randomized to angioplasty (n=149) or medical therapy (n=151).

Influence of the global utilization of streptokinase and tissue plasminogen activator for occluded coronary arteries (GUSTO-1) trial on the use of thrombolytics in Germany. ALKK Study Group. Arbeitsgemeinschaft der Leitenden Kardiologischen Krankenhausärtze.

Our results show significant and independent influence of the GUSTO-1 trial on the use of recombinant tissue plasminogen activator in acute myocardial infarction in Germany. This influence started soon after the publication of the trial and was not restricted to subgroups who benefitted most from recombinant tissue plasminogen activator.

PTCA registry of German community hospitals. Arbeitsgemeinschaft Leitender Kardiologischer Krankenhausärzte (ALKK) Study Group.

Background: Percutaneous transluminal coronary angioplasty (PTCA) is widely used, but no quality control has been systematically performed as yet.

Methods: A registry of all PTCA procedures has been established since October 1992 for the majority of the German community hospitals performing PTCA, representing about one third of all PTCA activity in Germany. Baseline demographic data, indication for PTCA, primary success and in-hospital clinical events were recorded.

Cardioversion of atrial fibrillation in the elderly. ALKK-Study Group. Arbeitsgemeinschaft Leitender Kardiologischer Krankenhausaerzte.

The purpose of this investigation was to define cardioversion success rates, frequency of complications of cardioversion, and current treatment practices in elderly patients (aged > or = 65 years) with atrial fibrillation (AF). The results were compared with those in younger patients (aged < 65 years). The investigation was a prospective multicenter observational study with 61 participating cardiology clinics.

Safety observations from the pilot phase of the randomized r-Hirudin for Improvement of Thrombolysis (HIT-III) study. A study of the Arbeitsgemeinschaft Leitender Kardiologischer Krankenhausärzte (ALKK).

Background: Adjunctive therapy for thrombolysis in acute myocardial infarction consists of platelet inhibition with aspirin and thrombin inhibition with heparin. Thrombin inhibition may be improved by the use of hirudin as indicated by experimental and phase II clinical studies. The randomized, double-blind phase III r-Hirudin for Improvement of Thrombolysis study (HIT III) compared a recombinant hirudin (HBW 023) with heparin.

[An improved guide catheter for percutaneous transluminal coronary angioplasty].

An improved guiding catheter (IGC) for PTCA is presented. The IGC's distal tip is formed into a slit. This provides two advantages: 1) Via the proximal portion of the slit, positioned in the sinus of Valsalva, coronary perfusion is assured.

Overcontraction and excess actin filaments. Basic elements of hypertrophic cardiomyopathy.

Endomyocardial biopsies were taken from the right ventricular aspect of the interventricular septum in three patients with hypertrophic cardiomyopathy and were subjected to electronmicroscopical examination. Longitudinal sections confirmed already well-established findings. In the transverse sections disarray in the arrangement of the actin filaments and expansion of the myosin lattice, indicating clear overcontraction, were observed.

[Reduction of myocardial ischemia by betablocker (Pindolol) in patients with acute infarction (author's transl)].

Seven patients with acute anterior myocardial infarction were treated with a betablocker (Pindolol 0.1-0.2 mg i.

[Prehospital phase of myocardial infarct].

After admission to the Coronary Care Unit 101 patients suffering from proved myocardial infarction were inquired about their prehospital phase. In the near future of the acute infarction the patients consulted their doctors more frequently. 73% had prodromi.

Effect of ethanol infusion on the ultrastructure of human myocardium.

To study the influence of a moderate dose of ethanol on the ultrastructure of myocardium in patients with heart disease, a 7·5% solution of ethanol was infused in six patients with myocardial and valvular disease, who underwent diagnostic cardiac catheterization. Before and after infusion of ethanol an endomyocardial biopsy was performed and the specimens were examined by electron microscopy. After ethanol all six patients revealed alterations in the mitochondrial structure and three of them also showed significant dilatation of the sarcoplasmic reticulum.